Diagnostic and imaging direction based on anatomical and/or physiological parameters

Abstract

Devices, systems, and methods of evaluating risk associated with a condition of the vessel and issuing an automatic recommendation based on co-registered physiological measurements are disclosed. The includes steps of obtaining image data for the vessel of the patient, obtaining physiological measurements for the vessel of the patient, co-registering the obtained physiological measurements with the obtained image data such that the physiological measurements are associated with corresponding portions of the vessel of the patient, analyzing the co-registered physiology measurements to identify a region of interest, and outputting, to a user interface, a suggested diagnostic procedure for the region of interest based on the analysis of the co-registered physiology measurements.

What is claimed is: 
     
       1. A system for evaluating a vessel of a patient, the system comprising:
 an intravascular catheter or guide wire configured to be positioned within the vessel of the patient; and 
 a processor configured for communication with an extravascular imaging system and the intravascular catheter or a guide wire, wherein the processor is configured to:
 receive, from the extravascular imaging system, extravascular image data for the vessel; 
 control the intravascular catheter or guide wire to obtain intravascular data of a first modality for the vessel; 
 co-register the intravascular data of the first modality with the extravascular image data; 
 determine, based on the co-registered intravascular data of the first modality, a region of interest of the vessel; 
 generate, based on the co-registered intravascular data of the first modality, a recommendation to obtain intravascular data of a different second modality at the region of interest of the vessel; and 
 output, to a display in communication with the processor, a screen display comprising:
 a graphical representation of the vessel based on the extravascular image data; 
 a graphical representation of the co-registered intravascular data of the first modality positioned at one or more corresponding first locations in the graphical representation of the vessel; and 
 a graphical representation of the recommendation positioned at a second location in the graphical representation of the vessel corresponding to the region of interest. 
 
 
 
     
     
       2. The system of  claim 1 , wherein the extravascular image data comprises at least one of two-dimensional angiographic image data, three-dimensional angiographic image data, or computed tomography angiographic (CTA) image data. 
     
     
       3. The system of  claim 1 , wherein the graphical representation of the vessel comprises at least one of an angiographic image or a three-dimensional model of the vessel. 
     
     
       4. The system of  claim 1 , wherein the intravascular data of the first modality comprises pressure data. 
     
     
       5. The system of  claim 4 , wherein the graphical representation of the co-registered intravascular data comprises one or more numerical pressure ratios calculated based on the pressure data. 
     
     
       6. The system of  claim 4 , wherein the graphical representation of the co-registered intravascular data comprises a coloring based on the pressure data and overlaid on the graphical representation of the vessel. 
     
     
       7. The system of  claim 1 , wherein the processor is configured to generate the recommendation to obtain the intravascular data of the different second modality based on geometric information generated from the extravascular image data. 
     
     
       8. The system of  claim 7 , wherein the geometric information comprises at least one of a dominance classification, a degree of occlusion of a lesion of the vessel, a classification of the lesion of the vessel, a degree of bending of the vessel, a length of the lesion of the vessel, or a degree of calcification of the lesion of the vessel. 
     
     
       9. The system of  claim 1 , wherein the processor is configured to automatically determine the region of interest based on the co-registered intravascular data of the first modality. 
     
     
       10. The system of  claim 9 , wherein the region of interest comprises a first region of interest, and wherein the processor is further configured to:
 automatically determine a second region of interest of the vessel based on the co-registered intravascular data of the first modality; 
 generate, based on the co-registered intravascular data of the first modality, a recommendation to obtain intravascular data of a third modality at the second region of interest of the vessel, wherein the third modality is different from the second modality. 
 
     
     
       11. The system of  claim 1 , wherein the intravascular data of the second modality comprises intravascular image data. 
     
     
       12. The system of  claim 11 , wherein the processor is further configured to receive, from an intravascular imaging device different from the intravascular catheter or guide wire, the intravascular image data, and wherein the screen display further comprises a graphical representation of the intravascular image data. 
     
     
       13. The system of  claim 11 , wherein the processor is further configured to determine a classification a lesion of the vessel based on the intravascular image data, and wherein the screen display further comprises a graphical representation of the classification of the lesion. 
     
     
       14. The system of  claim 1 , wherein at least one of the one or more first locations is the same as the second location. 
     
     
       15. The system of  claim 1 , wherein the one or more first locations are different from the second location. 
     
     
       16. The system of  claim 1 , further comprising the extravascular imaging system.